Gender issues in tuberculosis

Abstract

Tuberculosis (TB) is an infectious disease, caused by Mycobacterium tuberculosis. When aggregated by sex, global TB notification rates show more male cases of TB reported than female. Cases of smear-positive pulmonary TB also are reportedly higher for males than females. Tuberculosis bacteria usually infect the lungs, but infection can occur in any other organ. For reasons that are not completely clear, a higher proportion of extra-pulmonary TB occur among females than males. TB ranks as the second leading cause of death in humans from a single infectious disease globally, after HIV, and thus remains a global health concern although it is in fact a curable disease. Gender differences in health-seeking behaviors, including male-dominant utilization of TB diagnostic and screening services as well as the extent to which women have to negotiate their healthcare seeking, likely impact male-female differences in TB. Differences in the sensitivity of conventional molecular diagnostic tests as well as in the prevalence of multi drug-resistant TB can result in sex- and gender-based differences in treatment of TB. The role of co-infection with other pathogens, including HIV, as well as how biological differences between the sexes affect the prevalence and outcome of TB require additional consideration.